1993 health guide. Top 10 health stories to watch

A sea change seems likely in the way health care is delivered. In medicine, public health and nutrition, here's what else the year will bring.     

5.7 Environmental health service

Independent Local Politics in England and Wales,. W. P. Grant,. Farnborough: Saxon House, 1977, pp. 112. + vi, £7.50.

Organisation: A Guide to Problems and Practice, John Child, Harper and Row, 1977, pp. 243, £4.95 (hardback), £2.95 (paperback).

Emergency Employment—A Study in Federalism, Howard W. Hallman, University of Alabama Press, 1977, pp. 207, $11.50.

Commission for Local Administration in England — A Preliminary Appraisal, N. Lewis and B. Gateshill, R.I.P.A., 1978, pp. 68, £2.20.

Neighbourhoods and the Urban Economy, Benjamin Goldstein and Ross Davis (eds.), Lexington Books, 1977, pp. 160, £8.50.

Fiscal Management and Planning in Local Government, James C. Snyder, Lexington Books, 1977, pp. 306, £8.75.

Productivity in Local Government, Frederick O'R. Hayes, Lexington Books, 1977, pp. 295, £13.75.

Organisation and Staff Resources for Area Improvement, Part 1: General Approach, by The National Building Agency, November 1977, pp. 24, £1.00.     

Occupational safety and health

Work accidents became a matter of societal concern in the Progressive era of Woodrow Wilson. When other contingencies of modern life were brought under social security in the New Deal reforms of the 1930s, work accident legislation remained separate. One possible reason was that work accidents can be controlled within industrial and chance limits. But control does not imply elimination since a risk-free environment would paralyze production. In spite of imperfections caused by low benefits and imperfect insurance arrangements, the workers' compensation legislation does help internalize the costs of accidents, but internalization of costs is only one remedy. Regulation and a much broader community responsibility are others. It is argued that regulation poses greater problems and that broader community responsibility may evade the issues involved in choosing the appropriate tradeoff point between production and health which will maximize social welfare.     

Reform: health care

The Italian National Health Service was established in 1978 as three-tier system, involving State, Regions, USLs (Unità sanitarie locali, Local Health Care Units). The division between the responsibility of determining the general features of health care policy and financing it, on one side (the State), and that of managing services, on the order side (Regions and USLs), was bound to lead to increasing levels of expenditure and large financial deficits. An important reform has been carried out over the last five years, aiming toward a more decentralized system, which, although still public, were based on competition among suppliers and free choice for consumers. We argue that although the reform seems to have been successful in containing public expenditure, it has left some important issues still unresolved: the relationship between patients' freedom of choice and competition among providers, and the definition of a model of rationing the bundle of health services financed by the public sector.     

Top ten health trends

With advances in medicine, science and technology coming fast and furious, today's bold ideas could easily be tomorrow's standard operating procedures. To keep you abreast of developments in medicine, fitness and nutrition, U.S. News has identified the 10 most important health trends for the coming year. From gene therapy to patients' rights, here's a look at what's ahead.     

A guide to health reform

Answers in plain English to almost everything you ever wanted to know about the Clinton initiative--and how it could affect the medical care you get.